Endocrine最新文献

{"title":"Comparative efficacy and safety of orally administered PCSK9 inhibitors in patients with Hypercholesterolaemia: a dose-stratified systematic review and network meta-analysis.","authors":"Ahmed Talkhan, Mohamed Hamouda Elkasaby, Amr M Abou Elezz, Nermin Ezzat Borham, Ahmed Noureldeen Abbas, Ahmed W Abbas, Noha Hammad, Kareem Khalefa, Mazen Momtaz Shehata","doi":"10.1007/s12020-026-04805-2","DOIUrl":"10.1007/s12020-026-04805-2","url":null,"abstract":"<p><strong>Background: </strong>Injectable PCSK9 inhibitors are effective but remain under-used because of cost, the subcutaneous route, cold-chain storage and patient preference. Orally administered PCSK9 inhibitors, comprising two peptide-based agents and one small molecule, have recently completed phase 3 evaluation.</p><p><strong>Methods: </strong>We searched four databases from inception to 1 May 2026 for randomised trials of orally administered PCSK9 inhibitors versus placebo. A frequentist random-effects network meta-analysis treated each drug-dose combination as a separate node. The primary outcome was the mean percentage change from baseline in LDL-C, as a mean difference in percentage points (pp). Certainty was rated with CINeMA. Treatments were ranked by SUCRA with simulation-based 95% intervals; rankings are exploratory.</p><p><strong>Results: </strong>Five trials (4,227 participants) were included. All twelve drug-dose combinations reduced LDL-C versus placebo, most with NNC0385-0434 100 mg (- 61.8 pp, 95% CI - 78.1 to - 45.5), MK-0616 30 mg (- 60.9 pp, - 75.0 to - 46.8) and MK-0616 20 mg (- 58.5 pp, - 67.8 to - 49.2). Of 66 active-versus-active comparisons, the 51 between agents were wholly indirect; the 20 excluding the null all contrasted a low dose with a much higher one; none of the six among the four highest-ranked doses was significant, and their SUCRA intervals overlapped (0.42-1.00). Dose-response was significant for all three agents (P ≤ 0.005). Other lipid parameters also improved. Goal attainment was analysed separately by definition: against an absolute threshold, risk ratios were 4.36-9.73; against a composite of ≥ 50% reduction plus LDL-C < 70 mg/dL, MK-0616 20 mg gave a risk difference of + 68.9 pp. No short-term safety signal was detected. Heterogeneity (I² = 80.6%) reflected the comparison timepoint and fell to 0% at week 24.</p><p><strong>Conclusion: </strong>Oral PCSK9 inhibitors produce large, dose-dependent LDL-C reductions versus placebo with no short-term safety signal. Comparative rankings between agents and doses remain uncertain, and certainty of evidence is low.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newborn screening for congenital adrenal hyperplasia: a 3 years study embedded in 25 years of regional experience in Italy.","authors":"Gerdi Tuli, Jessica Munarin, Enza Pavanello, Luisa De Sanctis","doi":"10.1007/s12020-026-04759-5","DOIUrl":"10.1007/s12020-026-04759-5","url":null,"abstract":"<p><strong>Purpose: </strong>Newborn screening for congenital adrenal hyperplasia (CAH) using 17-hydroxyprogesterone (17-OHP) is hampered by high false-positive rates, especially in preterm and low birth weight infants. Second-tier strategies aim to improve specificity, but population-based data are limited. The aim was to evaluate CAH screening approach using birth weight-adjusted cut-offs and repeated sampling in a large regional cohort.</p><p><strong>Methods: </strong>We analyzed data from 90,092 infants screened in Piedmont, Italy (2019-2022). 17-OHP was measured in dried blood spots, with birth weight-adjusted thresholds and repeated sampling when indicated. 17-OHP distributions were examined by birth weight and gestational age, and outcomes assessed via recall rate and confirmed diagnoses.</p><p><strong>Results: </strong>Of 90.092 infants, 746 were recalled (0.82%), and 119 referred for specialist evaluation. Eight infants were diagnosed with classic salt-wasting CAH and one with non-classical CAH (incidence 1:11.261). 17-OHP concentrations inversely correlated with birth weight, capturing most biological variability. Repeated sampling significantly reduced false positives across all birth weight categories. Gestational age stratification offered no clear advantage over birth weight-based thresholds.</p><p><strong>Conclusions: </strong>Birth weight-based CAH screening effectively lowers false positives while identifying classic CAH. Refining percentile-informed cut-offs, particularly in higher birth weight infants, could further enhance efficiency without compromising safety.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for recurrent urinary tract infection after SGLT2 inhibitor reinitiation in type 2 diabetes.","authors":"Yu-Chu Hsueh, Chia-Hung Lin, Pi-Hua Liu, Yi-Hsuan Lin","doi":"10.1007/s12020-026-04777-3","DOIUrl":"10.1007/s12020-026-04777-3","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the risk of recurrent urinary tract infection (UTI) after early reinitiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in adults with type 2 diabetes and to identify patient-level factors associated with recurrence.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study. Adults with type 2 diabetes who discontinued an SGLT2i after an index UTI and were subsequently restarted were classified by reinitiation timing (early vs delayed). Recurrent UTI was defined as a new, clinically coded episode following reinitiation. Multivariable models assessed associations between recurrence and demographics, comorbidities, glycemic control, renal function, and psychiatric history.</p><p><strong>Results: </strong>Among 316 patients who restarted SGLT2i within 21 days during or after the first UTI episode, recurrent UTI occurred in 43.99% after 14 days post-reinitiation. In the combined cohort (n = 395), early reinitiation (<21 days) showed a trend toward increased recurrence risk compared to delayed reinitiation (≥21 days) in unadjusted Cox regression (HR 1.348; 95% CI 0.948-1.915; p = 0.096) and logistic regression (OR 1.305; 95% CI 0.797-2.139; p = 0.290), though neither reached statistical significance. After adjusting for baseline covariates, the trend persisted (adjusted Cox HR 2.011; 95% CI 0.973-4.158; p = 0.0592). In univariable Cox regression analysis of the combined cohort, female sex (HR 0.649 for males; 95% CI 0.448-0.942), higher HbA1c (HR 1.09 per %; 95% CI 1.004-1.184), and reduced eGFR (HR 0.992 per ml/min/1.73 m²; 95% CI 0.987-0.998) were identified as factors significantly associated with recurrence.</p><p><strong>Conclusions: </strong>In this retrospective cohort of patients whose UTI was clinically coded and treated with antibiotics, recurrence was less frequent among men with preserved renal function and lower HbA1c, suggesting early SGLT2i reinitiation is a reasonable option in this subgroup. No conclusion could be drawn for higher-risk patients. The comparison of early versus delayed reinitiation remained inconclusive: the point estimate favored delayed reinitiation but did not reach significance (adjusted HR 2.011; 95% CI 0.973-4.158). In univariable analysis, female sex, older age, poor glycemic control, and impaired renal function were associated with recurrence. As ascertainment required a coded encounter and an antibiotic prescription, these findings apply only to clinically significant episodes. Randomized trials are needed to define optimal timing.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of RET fusions on radioiodine avidity and prognosis in patients with distant metastatic papillary thyroid cancer.","authors":"Kexin Shi, Xinyue Zhang, Shuhui Huang, Tian Tian, Rui Huang","doi":"10.1007/s12020-026-04779-1","DOIUrl":"10.1007/s12020-026-04779-1","url":null,"abstract":"<p><strong>Background: </strong>RET gene fusion is one of the key oncogenic drivers in papillary thyroid cancer (PTC). However, the impact of different RET fusion subtypes on clinicopathological features and radioiodine (RAI) avidity in metastatic PTC remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed clinicopathological data, RAI avidity, and progression-free survival (PFS) in RET-driven metastatic PTC. Initial RAI avidity status was classified as initially RAI-avid (all or partial lesions showing uptake in the first therapy) or initially RAI-non-avid (all lesions with no uptake in the first therapy). The definition of RAI refractory (RAIR) was based on the 2025 ATA guidelines.</p><p><strong>Results: </strong>Among 65 enrolled patients, 25 (38.5%) harbored CCDC6-RET, 24 (36.9%) NCOA4-RET, and 16 (24.6%) other RET fusions. Older age was associated with the other RET fusion group (P = 0.011). NCOA4-RET patients were more likely to be initially RAI-avid (P = 0.017). Overall, 46.8% (29/62) of evaluable patients were classified as RAIR (CCDC6: 56.0%, NCOA4: 27.3%, other RET fusions: 60.0%; P = 0.072). TERT promoter mutation (18.2%, 8/44) in RET-fusion PTC was associated with older age (P < 0.001), larger metastatic lesions (P = 0.012) and metastatic sites beyond lungs (P = 0.002). RAIA patients demonstrated a longer median PFS compared with RAIR patients (86 vs. 33 months), but this association was not statistically significant (P = 0.402).</p><p><strong>Conclusion: </strong>In this metastatic RET-driven PTC cohort, 46.8% of evaluable patients eventually develop RAIR status. While the specific RET subtypes are associated with initial RAI avidity status, no significant differences in RAIR status or PFS were observed across distinct RET subtypes, warranting further exploration in larger sample sizes.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-thyroidal illness syndrome and isolated low triiodothyronine as prognostic markers in acute illness: a systematic review and meta-analysis.","authors":"Elisa Gatta, Virginia Maltese, Enrico Papini, Rinaldo Guglielmi, Roberto Negro, Massimo Salvetti, Carlo Cappelli","doi":"10.1007/s12020-026-04772-8","DOIUrl":"10.1007/s12020-026-04772-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association between thyroid hormone alterations and mortality in critically ill and cardiovascular patients, and to compare the prognostic performance of non-thyroidal illness syndrome and isolated low triiodothyronine.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Scopus, and Web of Science were systematically searched for studies published between 2014 and 2026 evaluating thyroid dysfunction and mortality in acute or critical illness. Studies assessing non-thyroidal illness syndrome or isolated low triiodothyronine were included. Random-effects meta-analyses were performed using odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Twenty-two studies were included. Fifteen studies evaluating non-thyroidal illness syndrome (5,230 patients) showed a significant association with mortality (OR 3.19, 95% CI 2.10-4.85), although heterogeneity was substantial (I²=67.5%, p<0.0001). Nine studies evaluating isolated low triiodothyronine (6,282 patients) also demonstrated a significant association with mortality (OR 2.93, 95% CI: 2.04-4.20), with substantial heterogeneity (I²=63.8%, p = 0.0048). Subgroup comparison and exploratory meta-regression showed no significant differences in effect size between the two definitions of thyroid dysfunction.</p><p><strong>Conclusions: </strong>Both non-thyroidal illness syndrome and isolated low triiodothyronine are associated with increased mortality in critically ill and cardiovascular patients. Although current aggregate data do not demonstrate a clear quantitative superiority of one definition over the other, non-thyroidal illness syndrome may provide a more integrated biological framework for interpreting thyroid dysfunction during acute illness.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiometabolic significance of post-dexamethasone cortisol levels below the MACS threshold in adrenal incidentaloma.","authors":"Elif Seray Korkmaz, Birsen Öztürk Gökçe, Medine Nur Kebapçı","doi":"10.1007/s12020-026-04794-2","DOIUrl":"10.1007/s12020-026-04794-2","url":null,"abstract":"<p><strong>Purpose: </strong>Although post-dexamethasone suppression test (DST) cortisol levels ≤ 1.8 µg/dL are generally considered compatible with nonfunctioning adrenal tumors, accumulating evidence suggests that cardiometabolic risk may vary even below the threshold for mild autonomous cortisol secretion (MACS). This study aimed to evaluate cardiometabolic risk across different post-DST cortisol levels in patients with adrenal incidentaloma using conventional metabolic parameters and atherogenic indices.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, 156 patients with adrenal incidentaloma were classified into three groups according to post-DST cortisol levels: ≤0.9 µg/dL (Group 1, n = 48), 0.91-1.79 µg/dL (Group 2, n = 60), and ≥ 1.8 µg/dL (Group 3, n = 48). Demographic characteristics, blood pressure, glucose metabolism parameters, lipid profiles, and cardiometabolic risk indices, including the triglyceride-glucose (TyG) index, plasma atherogenic index (PAI), and Castelli Risk Indices I and II, were compared among groups. Correlations between post-DST cortisol levels and cardiometabolic parameters were evaluated using Spearman correlation analysis.</p><p><strong>Results: </strong>Blood pressure and the prevalence of hypertension increased significantly across post-DST cortisol categories. Notably, Group 2 already differed significantly from Group 1 in systolic and diastolic blood pressure and hypertension prevalence. Diabetes mellitus was also more prevalent in Group 2 than in Group 1. Fasting glucose, HbA1c, total cholesterol, LDL cholesterol, and non-HDL cholesterol differed significantly among the three groups, with Group 2 showing significantly higher HbA1c and LDL cholesterol than Group 1. The TyG index and Castelli Risk Indices I and II also differed significantly across cortisol categories, although pairwise differences for these indices were primarily observed between Groups 1 and 3. Overall, Group 2 exhibited an intermediate cardiometabolic pattern between Groups 1 and 3. Post-DST cortisol levels were positively correlated with blood pressure, glucose metabolism parameters, atherogenic lipid parameters, and several atherogenic indices.</p><p><strong>Conclusion: </strong>Post-DST cortisol levels were associated with a graded pattern of cardiometabolic risk among patients with adrenal incidentaloma. Patients with post-DST cortisol levels of 0.91-1.79 µg/dL exhibited an intermediate cardiometabolic phenotype, with significant abnormalities in several cardiometabolic parameters compared with patients with more complete cortisol suppression. These findings suggest that patients below the current MACS threshold may not represent a metabolically homogeneous or uniformly benign population and support further prospective investigation of cardiometabolic risk across the continuum of post-DST cortisol levels.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growing up with Klinefelter syndrome: challenges of care in children and adolescents and patients advocacy.","authors":"Chiara Mameli, Maria Elisabeth Street, Mirta Vernice, Luigi Tarani, Camilla Valsecchi, Giulia Fiore, Cecilia Lugarà, Roberto Paparella, Anna Mariia Shulhai, Pamela Pedretti, Annapia Verri, Elvira Verduci, Malgorzata Wasniewska, Tommaso Aversa","doi":"10.1007/s12020-026-04802-5","DOIUrl":"10.1007/s12020-026-04802-5","url":null,"abstract":"<p><p>Klinefelter syndrome (KS) is a common, yet underdiagnosed sex chromosome aneuploidy characterized by considerable phenotypic variability and multisystem involvement beginning in early life. The increasing use of noninvasive prenatal testing has led to earlier diagnosis, highlighting the need to redefine clinical management across the pediatric age. In this narrative review, pediatric endocrinologists, neuropsychiatrists, psychologists, and genetic experts critically examine current evidence on genetic mechanisms, growth, pubertal development, cardiometabolic risk, and neuropsychological features of KS, and includes a dedicated patient advocacy perspective highlighting family priorities and unmet needs. Emerging evidence indicates that altered body composition, insulin resistance, and neurodevelopmental vulnerabilities may arise in childhood, often preceding overt hypogonadism. Language impairment, executive dysfunction, and social cognitive difficulties represent key determinants of functional outcomes and require early recognition. Early childhood represents a window of opportunity for targeted interventions. A proactive, multidisciplinary, and preventive approach is essential to optimize long-term clinical, cognitive, and social outcomes in individuals with KS.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of cytokines relating to masked obesity in Japanese women.","authors":"Chisaki Ishibashi, Kaori Nakanishi, Makoto Nishida, Kiyoshi Masuyama, Maki Shinzawa, Daisuke Kanayama, Ryohei Yamamoto, Toshiki Moriyama, Izumi Nagatomo, Keiko Yamauchi-Takihara","doi":"10.1007/s12020-026-04788-0","DOIUrl":"10.1007/s12020-026-04788-0","url":null,"abstract":"<p><strong>Background: </strong>Masked obesity (MO) has been associated with chronic inflammation; however, its immunological profile has not been extensively studied.</p><p><strong>Objective: </strong>This exploratory study aimed to investigate immunological profile in MO by examining serum cytokine levels and clinical characteristics in individuals with reduced muscle mass and increased fat.</p><p><strong>Methods: </strong>Body composition was assessed in 432 female employees of The University of Osaka (aged 30-59 years) using InBody270 during health examinations. Participants with skeletal muscle mass index (SMI) ≥ 5.7 kg/m² and percent body fat (PBF) < 30% were classified as the healthy (H) group, while those with SMI < 5.7 kg/m² and PBF ≥ 30% were classified as the MO group. Serum cytokine concentrations were measured in randomly selected participants, 34 from the H group and 24 from the MO group.</p><p><strong>Results: </strong>Compared to the H group, the MO group had significantly higher triglyceride (p < 0.0001), low-density lipoprotein cholesterol (p = 0.0047), and insulin (p = 0.0008) levels, and significantly lower grip strength (p < 0.0001). Interleukin-17 C levels (unadj. p = 0.017, q = 0.33), colony-stimulating factor-1 (unadj. p = 0.051, q = 0.33) and lymphotoxin-alpha (unadj. p = 0.053, q = 0.33) levels tended to be lower, and interleukin-6 (unadj. p = 0.049, q = 0.33), C-C motif chemokine ligand (CCL) 8 (unadj. p = 0.064, q = 0.33) and CCL2 (unadj. p = 0.066, q = 0.33) levels tended to be higher in the MO group than in the H group.</p><p><strong>Conclusion: </strong>This exploratory study demonstrates that MO might be associated with circulating levels of some cytokines, suggesting that these cytokines could be potential biomarkers for MO.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of coexisting celiac disease with macrovascular and microvascular complications in adults with type 2 diabetes mellitus: a retrospective propensity score-matched cohort study.","authors":"Renan Prado, Melissa Lou Silva","doi":"10.1007/s12020-026-04769-3","DOIUrl":"10.1007/s12020-026-04769-3","url":null,"abstract":"<p><strong>Background: </strong>Celiac disease (CD) and type 2 diabetes mellitus (T2DM) are increasingly recognized as overlapping metabolic conditions. However, the impact of concomitant CD on diabetes-related complications and metabolic outcomes in patients with T2DM remains poorly characterized. We aimed to compare clinical outcomes between patients with T2DM and CD versus patients without CD.</p><p><strong>Methods: </strong>We performed a retrospective multicenter electronic health record (EHR)-based cohort study using the TriNetX research network. Adults with T2DM and concomitant CD were identified using ICD-10-CM codes for T2DM and CD, along with either markedly elevated tissue transglutaminase IgA levels or upper endoscopy procedures. Propensity score matching (1:1) was performed for demographics, cardiovascular risk factors, lipid disorders, medications, and laboratory markers, yielding 8,760 patients per cohort. Outcomes included albuminuria, depression, anxiety, severe hyperglycemia, ophthalmic complications, hospitalization, neuropathy, nephropathy, and a composite cardiovascular outcome.</p><p><strong>Results: </strong>After matching, patients with T2DM and CD had significantly higher hazards of albuminuria (HR 1.30, 95% CI 1.15-1.46), depression (HR 1.14, 95% CI 1.07-1.21), anxiety (HR 1.12, 95% CI 1.06-1.18), severe hyperglycemia (HR 1.39, 95% CI 1.27-1.53), ophthalmic complications (HR 1.77, 95% CI 1.55-2.02), neuropathy (HR 1.73, 95% CI 1.59-1.88), nephropathy (HR 1.13, 95% CI 1.04-1.22), and a composite cardiovascular outcome (HR 1.09, 95% CI 1.01-1.17) compared with matched controls. Hospitalization risk did not differ between cohorts (HR 0.97, 95% CI 0.92-1.01). Mean follow-up after matching were 1,574 days and 1,438 days.</p><p><strong>Conclusions: </strong>Among patients with T2DM, concomitant CD was associated with significantly higher risks of macro and microvascular diabetic complications, and psychiatric comorbidities.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, ultrasonographic, and cytological characteristics of niftp and postoperative outcomes: a retrospective cohort study.","authors":"Ekin Yiğit Köroğlu, Cevdet Aydin, Çağlar Keskin, Ayşegül Aksoy Altinboğa, Asiye Şafak Bulut, Buket Altun Özdemir, Oya Topaloğlu, Reyhan Ersoy, Bekir Çakir","doi":"10.1007/s12020-026-04789-z","DOIUrl":"10.1007/s12020-026-04789-z","url":null,"abstract":"<p><strong>Purpose: </strong>Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is an indolent thyroid neoplasm that cannot be definitively diagnosed before surgery. We aimed to describe the preoperative clinical, ultrasonographic and cytological characteristics of patients with NIFTP and to assess their postoperative outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included 165 adult patients with a histopathological diagnosis of NIFTP managed at a single tertiary center between January 2019 and July 2025. Demographic, biochemical, ultrasonographic (EU-TIRADS and ATA ultrasound risk stratification), cytological (Bethesda system) and follow-up data were analyzed. Outcome analyses were restricted to patients with isolated NIFTP.</p><p><strong>Results: </strong>Most patients were female (84.8%), with a mean age of 49.99 ± 12.61 years, and autoimmune thyroiditis was present in 26.7%. On ultrasound, 73.3% of nodules were classified as EU-TIRADS 2-3 and 73.9% as ATA low risk, with nearly identical distributions between the two systems. Among biopsied nodules, 41.8% fell into indeterminate Bethesda categories (III-IV), with Bethesda III being the most frequent, while 5.0% were classified as suspicious for malignancy (Bethesda V). Concurrent papillary thyroid carcinoma was identified in 41.2% of patients. Among the 97 patients with isolated NIFTP, no lymph node metastasis or structural recurrence occurred over a median follow-up of 28.0 (IQR 17.0-40.0; range 6-76) months, and only one patient received radioiodine.</p><p><strong>Conclusion: </strong>NIFTP showed predominantly low-risk ultrasonographic and indeterminate cytological features, frequent coexisting carcinoma, and an excellent prognosis. These findings support conservative management, while the absence of dedicated follow-up recommendations warrants continued surveillance.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":"91 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}